The Lagos University Teaching Hospital (LUTH) is a Federal Government owned tertiary health care provider located in Idi-Araba, Surulere Lagos. It is one of twin organisations (alongside The College of Medicine of the University of Lagos) established by the Federal Government of Nigeria for the education and training of medical personnel (undergraduate and post-graduate) as well as for providing specialised medical care for patients.

This is a two-fold review of my LUTH experience as a Medical Student and as a Patient.

LUTH employs thousands of workers and they range from the highly specialised consultant doctors to cleaners, and all work in tandem to ensure that the patient has a memorable experience during their treatment and rehabilitation in the hospital. But Alas! The experience, while always memorable, isn’t always savoury and thus to the common man, the hospital is a recipient of mixed reviews. Some believe that LUTH is the pinnacle of Nigerian medical science and thus is Nigeria’s last beacon of hope to the ailing and to the deathly ill. Well, that belief isn’t entirely unfounded as LUTH currently boasts, by a wide margin, of the highest amount of specialist doctors in any Nigerian hospital and thus patients are guaranteed knowledgeable professionals in their search for resolution of specific illnesses. Others believe LUTH to be the devil’s own receptacle, hence the saying; “You only go to LUTH for treatment when you are ready to die”. To the average observer of the Accident and Emergency department of LUTH, which is often the main point of entry into the hospital, there appears to be an awful amount of death going on as every other half-hour, you see a corpse getting wheeled out and all you see is either the bustle of the relatives of those hanging on to life by a thread or the sorrow of relatives who have just lost a loved one. The truth about any hospital is that not all the patients that come in are going to leave alive and what every hospital does is to maximise the chances of survival of their patient.

At LUTH, there’s the caste system of seniority with each level being firmly under the next; Consultant, Senior Registrar, Junior Registrar, House Officer, Medical Student. Doctors go on rounds (in groups) everyday, checking up on each patient that has been placed in care of their units but due to the sheer amount of patients remitted to each unit, these doctors are unable to spend more than just a few minutes at each patient’s bedside. All they check for are the basics; stability of the patient, improvements or new devolvement and then they make their comments in case notes. The Consultant Ward rounds are worse as most Consultants are more interested in discussing the patients and ‘tackling’ the knowledge of the junior doctors, as opposed to actually checking up on the patient. So what a Consultant round often yields is just a confirmation of the observation of resident doctors and nothing more. At night, there often are doctors from each unit ‘on call’ in each ward but in reality, only a House Officer is present and this persons sole job is to disturb his superior only when the patient’s case has gotten out of hand and often at death.

There is the Bureaucratic Inter-departmental passing of the buck in which various departments or units (especially those at loggerheads) constantly reject patients referred to them or dally in their acceptance of such referrals. There’s also interdepartmental conflict (what a lay man would relate to as friction). Take for instance, the ward rounds. During these rounds as a student, you get to witness this friction on first hand basis. A practical example can be seen in a case of an accident victim. The consultant instructs that the patient should be ambulated (start walking re-education) and the physiotherapist who specialises in this area insists that the patient isn’t fit to start walking. Both practitioners end up confusing the patient. Nurses are not exempt from this practice as you often have nurses who conclude that their patient’s moans of pain and discomfort are just a ploy to get attention (duh, that’s why they are in a hospital). So the nurses busy themselves chatting away while their ‘attention-seeking’ patients slowly moan to their deaths then there is the rush of ‘writing memos’ which are simply devices of absolving themselves of blame in a patient’s death. Most patients don’t even know that there’s something called Rights and Responsibilities of the patient. These patients are left at the mercy of the medical practitioners, who are not to be blamed most times because of the swamp of patients in their care and degenerating facilities available for patient care.

Patients of the hospital often accuse their care-givers of negligence, however, the LUTH employees counter this accusation with the argument of being effectively under-staffed. Take for instance, the average ward which contains 28 beds, most of which are occupied by critically ill patients who require much attention. Such a ward is manned for most of the day by 4 nurses who are then required to use their discretion in deciphering which patients to attend to and at what time.

My own first hand experience as a patient in LUTH: On this particular day I had this deep cut on my foot from a broken glass. I was rushed to Accidents and Emergency and on getting there, the nurses totally ignored me with the excuse that the nurse meant to attend to me wasn’t on her work post. I spent close to 2hours before I was attended to (not regarding the fact that I am a Medical Student). This definitely shouldn’t be the case in a prestigious hospital like LUTH. It is called Accidents and Emergencies for the intention of all cases passing through to be treated as emergencies. When all is said and done, LUTH is one of the major health providers in the country and I must say that I feel privileged having had the LUTH experience. Like every other organisation, LUTH is subject both to the advantages and the disadvantages of having human beings work together in tandem towards a common goal and these disadvantages, in my opinion, are more magnified at LUTH as the the doctors are highly cerebral, well-read people with huge egos. The organisation is just a potpourri of egos where each department’s sole goal is to prove themselves better than the next and not necessarily to help their patients attain good health or get better.

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About a Month ago, I went to the dental clinic in LUTH to book an appointment. With one of the doctors for my 4th procedure which is a Root canal Therapy Procedure ( I will put up a review on other procedures) . The doctor told me the exact day I should come and the time too .

My appointment was scheduled for the 18th of September 2013, 9am .
I headed over to the dental clinic as early as 8:30am to avoid excuses from the doctor . When I got to the clinic , I discovered that only nurses were on duty and doctors were missing and since I’m not very keen on listening to the news, I would have known that the Resident doctors are currently on strike .

I remember that about 3 weeks ago, the House officers I.e New doctors went on strike too in LUTH because a lot of them were not paid , the government was owing some for about 7 months , before the H.O’s went on strike , The Nurses had their own strike too , Now resident doctors too are been owed about 3 months salary.

Do we Have a Minister of Health in Nigeria ?
What is the government doing about this ?
Where is Nigeria’s Money Going to ?
Is the Health Sector Not important ?
When are they calling off their strike ?
Isn’t this Affecting patients ?

On the 10th of July 2013, we were in the Anatomy lab with the cadavers and formalin. Of course, we know how terrible the smell of formalin is. (For those who don’t know what Formalin is, it’s a chemical that’s used to preserve dead bodies and it has the worst smell, it affects the eyes, skin etc. And cadavers are the dead bodies that medical students perform their dissection on). Then all of a sudden, we heard people shouting and of course, we ran towards the direction of the noise. Only to find out that a friend of mine (lets call her S) fainted. I was pretty scared; I didn’t even know what to think. Different things were running through my mind as to the cause of her fainting. People had already begun talking; ‘maybe she’s pregnant ‘, ‘maybe she has been jacking too much’.

We rushed S to the teaching hospital where she was immediately taken into the A&E (Accidents and Emergencies) unit. As much as I would hate to admit it, we all knew she was given preferential treatment cause she’s a student. I know a lot of people who complain about waiting a long while before being attended to in LUTH, which of course is wrong. And because it was an emergency, we weren’t asked for money or anything like that at first.

A doctor attended to S almost immediately. But the A&E was crowded and they were short staffed. There was no room to place her in so she was taken to the consulting room. Although she was given drips and the basic tests like blood pressure, blood sugar, etc. were done,they were done in the consulting room, which was wrong. The doctor kept moving all over the place cause like I said, they were short staffed and he had other patients to attend to. After some time, the A&E doctor handed my friend over to another doctor who was on call at that moment. S was then given some papers and sample bottles to take some tests in the lab.

When a friend of mine (lets call her Z) went to the lab to submit the samples, she was asked for money. Z explained that she’s a student and they asked for ‘the Retainership letter’ (when you’re sick in school, as a student, you write a letter to the Dean of students’ affairs who’ll in turn give you a note (aka Retainship letter) which you’ll take to the PRO of LUTH with your ID Card and the likes). The letter is basically to subsidize the cost of the treatment to be received. So because we didn’t have the Retainership letter and we didn’t have enough cash to pay, we couldn’t perform the tests.

S was admitted later that day. A lot of doctors came in to check on her, at a point it got annoying, because we were all like ‘please who is the particular doctor attending to her?’ Not the one that different people will come and touch and check different things. Anyway, it was getting late so we all had to go. Her boyfriend and another friend slept over in the room with her.

The next morning, she took the last test she was asked to do, which was like the conclusion test. So we got the results back and what next, of course we couldn’t just leave the hospital like that. We needed a doctor’s final conclusion, Signature and affirmation that she was free to go. Now, that’s where the bigger problem was. After doing the test, we got back to the A&E unit and started looking for a doctor to sign the results and discharge her. There was none to be found. We even resulted to meeting doctors on the corridors. Like, we started asking random doctors if they could help us, they all kept telling us that they were in surgery department and not in medicine. It was so frustrating. We searched everywhere! We got the test results by 1pm and finally left the hospital at about 6:30pm. That’s how bad it was. Luckily for us, that evening we found one of the nice doctors that attended to her the first day. So he quickly discharged her and we left. Only God knows when we would have left there if we didn’t find that doctor.

The main point of this review is to point out the fact that in LUTH, we’re dealing with lives. The standard has to be improved. Waiting for eternity to be attended to, shortages of staff, etc, these things have to stop in order to increase efficiency and reduce the death rate in LUTH. I know we’re all trying and it’s not an easy task but the lives of human beings are at stake here. Let’s try to make things better, at least to the best of our abilities. Am using ‘us’ here because as much as those in charge of LUTH are responsible, we can’t leave everything to them. We all have a hand in the future of not just LUTH, but Nigeria as a whole.

What is there to trust in LUTH. This is supposed to be one of the best hospitals in Nigeria, Everybody coming in here should say their last prayers . Death is certain even with Malaria. Luth is a disappointment .
This LUTH surgeons killed the most important person in my life . Something that is so minor , I pray to God that nothing will take any of my Loved ones to LUTH

nice expose! We wld all agree that in all organizations we have the good & the bad ; dis is a health organization where d “Bad” should not be an option. Because no matter how many Gd eggs we have, a bad 1 can make it all bad…… beautiful article, well said

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